The prevalence of cervical abnormalities: Comparison of youth with perinatally acquired HIV and older women in Botswana.

Abstract

Cervical cancer burden and prevalence of precursor lesions is unknown among young women living with HIV in high prevalence settings. Current cervical cancer screening guidelines in resource-limited settings with high HIV prevalence typically exclude adolescents and young women. After observing two cases of advanced cervical cancer among young women with perinatally acquired HIV, a pilot screening programme was established in Botswana. To compare the prevalence of cervical abnormalities in young women with perinatally acquired HIV with women aged 30-49 years, regardless of HIV status. We conducted a cross-sectional study of 30-49-year-old women who had visual inspection with acetic acid screening through the Botswana public sector programme, and youth (aged 15-24 years) with perinatally acquired HIV, at a single referral site between 2016 and 2018. We describe the prevalence of cervical abnormalities in each group as well as the crude prevalence ratio. The prevalence of cervical abnormalities in women 30-49 years of age was 10.9% (95% confidence interval [CI]: 10.4, 11.4), and 10.1% (95% CI: 4.7, 18.3) for youth. The crude prevalence ratio was 1.07 (95% CI: 0.58, 2.01). Inclusion of youth living with HIV in cervical cancer screening services should be considered in settings with a high prevalence of HIV and cervical cancer.